PURPOSE: Recently, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in Korea. However, there have been few studies on the epidemiology of VRE colonization among neonates. In this study, we investigated the prevalence of VRE colonization, risk factors for VRE, and how to control the spread of VRE infection in the Neonatal Intensive Care Unit (NICU) of Pusan National University Hospital (PNUH). METHODS: We retrospectively reviewed medical records of 192 neonates who were admitted to the NICU of PNUH from March 2006 to March 2007. Surveillance cultures from rectal swabs for detecting VRE were obtained weekly during the study period. We analyzed the prevalence of VRE and various risk factors. RESULTS: The rate of VRE colonization among NICU patients was 25% (48/192). Thirty five of these VRE colonized patients were transferred to the NICU from other local hospitals. Compared with the non-VRE group, the risk factors associated with VRE colonization were lower birth weight, congenital heart disease, applied mechanical ventilation, use of a central venous catheter, chest tubing, a history of surgery, and use of antibiotics. CONCLUSION: VRE colonization among patients admitted to the NICU is rapidly increasing. Monitoring and managing premature neonates from the beginning of the birth process, avoiding many invasive procedures, avoiding antibiotics such as vancomycin and third generation cephalosporin are important for preventing the emergence and spread of VRE colonization in the NICU.
Anti-Bacterial Agents ; Birth Weight ; Central Venous Catheters ; Colon ; Heart Diseases ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Korea ; Medical Records ; Parturition ; Prevalence ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Thorax ; Vancomycin ; Vancomycin Resistance

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has had significant physical and psychological impacts on registered nurses (RNs). This study aimed to identify long COVID symptoms and their associated factors specifically among RNs. Methods: This descriptive correlational study’s sample comprised 189 nurses (31.57±5.98 years, 93.7% female) in Korea. Self-reported long COVID symptoms were assessed using the COVID-19 Yorkshire Rehabilitation Scale. Data were collected from December 31, 2022, to January 13, 2023, using the online survey method and were analyzed using independent t-test, Wilcoxon signed-rank test, one-way ANOVA, Pearson’s correlation, and a multiple linear regression analysis with the IBM SPSS Statistics 26.0 program. Results: A total of 179 participants (94.7%) experienced one or more long COVID symptoms. The most prevalent symptoms were weakness (77.8%), fatigue (68.3%), breathlessness (67.7%), cough/throat sensitivity/voice change (50.3%), and sleep problems (50.3%). The factors related to long COVID symptoms were marital status, type of institution, working time, acute COVID-19 symptoms, and vaccination status. The quarantine period (β=.26, p<.001) and the nursing workforce after COVID-19 (β=-.17, p=.018) were significantly associated with long COVID symptoms (Adjusted R2=.33). Conclusion Providing comprehensive recognition is necessary for the understanding of long COVID symptoms and their associated factors among nurses and could promote a long COVID symptom management education program targeted at nurses. Moreover, it could facilitate effective nursing care and education plans for long COVID patients.

No abstract available.
Fluconazole* ; Tinea Capitis* ; Tinea*

PURPOSE: The purpose of this study was to examine the awareness of fathers about early childhood parenting. METHODS: Selected fathers of children in early childhood were interviewed, and an open-ended questionnaire was utilized to identify the fathers' awareness of the meaning of parenting, priority for parenting, opinions on paternal roles as a child raiser, parenting difficulties, and what education they wanted to receive as fathers. After their statements were collected, a content analysis was done. RESULTS: Results of the content analysis showed there were 45 significant statements, which were classified into 17 categories. The fathers saw the meaning of parenting as being in five different domains: social, cognitive, emotional, physical and environmental. As for paternal roles, they thought that a fathers should serve as emotional supporters. The parenting difficulties that they faced were attributed to time constraints. CONCLUSION: For fathers, development of parent education programs that deal with early childhood parenting knowledge, communication methods and how to play with children according to their developmental stages are required, and qualitative research should be implemented to keep track of the process of changes in parenting characteristics.
Child* ; Education ; Fathers* ; Humans ; Parenting* ; Parents* ; Qualitative Research ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to examine the awareness of fathers about early childhood parenting. METHODS: Selected fathers of children in early childhood were interviewed, and an open-ended questionnaire was utilized to identify the fathers' awareness of the meaning of parenting, priority for parenting, opinions on paternal roles as a child raiser, parenting difficulties, and what education they wanted to receive as fathers. After their statements were collected, a content analysis was done. RESULTS: Results of the content analysis showed there were 45 significant statements, which were classified into 17 categories. The fathers saw the meaning of parenting as being in five different domains: social, cognitive, emotional, physical and environmental. As for paternal roles, they thought that a fathers should serve as emotional supporters. The parenting difficulties that they faced were attributed to time constraints. CONCLUSION: For fathers, development of parent education programs that deal with early childhood parenting knowledge, communication methods and how to play with children according to their developmental stages are required, and qualitative research should be implemented to keep track of the process of changes in parenting characteristics.
Child* ; Education ; Fathers* ; Humans ; Parenting* ; Parents* ; Qualitative Research ; Surveys and Questionnaires

Objective: This study aimed at providing a critical review of the overall benefits of the chin-tuck maneuver through a systematic review of its effects when used in the treatment of dysphagia, as well as to provide basic data for a comparative analysis in future studies. Methods: To identify academic papers on the chin-tuck maneuver published from January 2000 to January 2021, a literature search on three databases was performed using keywords, including chin-tuck, dysphagia, and head flexion. Out of the 712 related papers identified, the methodological characteristics and results of 12 selected studies were reviewed. Results: Nine of the 12 studies found that the chin-tuck position not only helped in the opening of the upper esophageal sphincter (UES) but also reduced pharyngeal residues and prevented aspiration and penetration. In addition, three studies analyzed the position of the neck flexion angle and the changing angle when performing the chin-tuck maneuver. Conclusion This shows that the chin-tuck maneuver is an effective strategy in the treatment of dysphagia. In future studies, further investigation of the posture, angles, and effects of the chin-tuck maneuver, could help identify additional benefits of this treatment.

BACKGROUND: Necrotizing fasciitis is a life-threatening soft tissue infection involving the fascia and subcutaneous tissues. Diagnosis of necrotizing fasciitis is often delayed because of an underestimation or an overlap between it and cellulitis. OBJECTIVE: We aimed to evaluate and compare the clinical, laboratory, and microbiological characteristics of cellulitis and necrotizing fasciitis. METHODS: We retrospectively reviewed medical records of patients diagnosed as having cellulitis or necrotizing fasciitis and hospitalized at our hospital between January 2011 and December 2016. RESULTS: The study included data from 185 patients having cellulitis and 33 patients having necrotizing fasciitis. There were significant differences between cellulitis and necrotizing fasciitis regarding clinical and laboratory factors. Necrotizing fasciitis was primarily associated with the following features at the time of admission: A thigh/buttock location [odds ratio (OR) 9.04, 95% confidence interval (CI) 1.72∼47.64, p=0.009], pain not controlled with use of non-opioid analgesics (OR 6.26, 95% CI 2.21∼17.71, p<0.001), serum sodium level <135 mEq/L (OR 17.44, 95% CI 7.27∼41.84, p<0.001), and a serum procalcitonin level >0.32 ng/mL (OR 9.41, 95% CI 4.18∼21.93, p <0.001). Additionally, polymicrobial infections and Gram-negative organisms were more commonly associated with necrotizing fasciitis compared to cellulitis. CONCLUSION: We found several differences between cellulitis and necrotizing fasciitis in terms of clinical, laboratory, and microbiological characteristics. When patients showing symptoms of cellulitis present with lesions on the thigh or buttock, pain not controlled with use of non-opioid analgesics, a serum sodium level <135 mEq/L, or a procalcitonin level >0.32 ng/mL, it would be appropriate to evaluate for the possibility of necrotizing fasciitis and use broad-spectrum antibiotics to cover for Gram-negative organisms.
Analgesics ; Anti-Bacterial Agents ; Buttocks ; Cellulitis* ; Coinfection ; Diagnosis ; Fascia ; Fasciitis, Necrotizing* ; Humans ; Medical Records ; Retrospective Studies ; Sodium ; Soft Tissue Infections ; Subcutaneous Tissue ; Thigh

Background: This study aimed to analyze the medical expenses covered by the Korean National Health Insurance Service (KNHIS) according to body mass index (BMI) in Korean adults. Methods: We included 1,170,464 adults (623,498 men and 546,966 women) aged ≥19 years from the KNHISNational Sample Cohort database (2016 to 2019) after excluding individuals with cancer. Average annual medical expenses per person and average annual medical expenses (Korean won [KRW], 1 United States dollar=1,292 KRW) by BMI classification were assessed according to age and sex. Medical expenses comprised those for medication and combined outpatient department (OPD) and hospitalization services. Means and 95% confidence intervals were analyzed using a two-part model. Results: Average annual medical expenses increased in higher BMI quintile groups (P for trend <0.001). Average annual medical expenses per person increased significantly as BMI increased in women but not in men. Average annual medical expenses were highest in the highest quintile of BMI among women and in all age groups.While BMI showed a U-shape association with medical expenses for OPD and hospitalization in young individuals, medical expenses for medication in all age groups and those for OPD and hospitalization in middle-aged individuals increased sharply in the highest BMI quintile. Conclusion All types of average annual medical expenses increased in higher BMI groups in Korean adults, particularly in women. Individuals with the highest BMI quintile incurred the greatest medical expenses among women and across all age groups. Strategies for preventing and managing obesity are warranted to reduce the burden of obesity-related medical expenses.

This study aimed to provide basic data for promoting healthy food choices by evaluating the energy and nutrient content of ready-to-cook or ready-to-heat home meal replacement snacks. Eight hundred and ninety-four flour-based home meal replacement (HMR) products were analyzed, including 367 noodle dishes, 230 tteokbokki products, and 297 dumpling items. The serving sizes were determined by the product labeling. If not indicated, the total weight was used as the serving size if it could be considered a single serving. A serving size of 150 g was applied to dumplings sold in large packages. The average serving size was 249.9 g for noodles and 210.0 g for tteokbokki. The energy content varied significantly: noodles, tteokbokki, and dumplings had 439.8 kcal, 433.0 kcal, and 292.7 kcal, respectively (P＜0.001). The carbohydrate content were higher in noodles (87.9 g) and tteokbokki (87.6 g) compared to dumplings (32.0 g) (P＜0.001), while the sugar content was highest in tteokbokki (13.5 g) (P＜0.001). The protein content was highest in noodles (11.7 g), followed by dumplings (10.9 g) and tteokbokki (9.9 g) (P＜0.001). The sodium content was highest in noodles (1,777.9 mg), followed by tteokbokki (1,152.3 mg) and dumplings (583.7 mg) (P＜0.001). The price per serving was highest for noodles (3,303.9 KRW) (P＜0.001). The nutrient content varied within the same product type depending on the flavor, temperature (hot vs. cold), and whether a broth was included.These findings highlight the considerable differences in nutritional profiles among HMR snack foods and underscore the importance of selecting products based on their intended dietary use.

Background: This study aimed to analyze the medical expenses covered by the Korean National Health Insurance Service (KNHIS) according to body mass index (BMI) in Korean adults. Methods: We included 1,170,464 adults (623,498 men and 546,966 women) aged ≥19 years from the KNHISNational Sample Cohort database (2016 to 2019) after excluding individuals with cancer. Average annual medical expenses per person and average annual medical expenses (Korean won [KRW], 1 United States dollar=1,292 KRW) by BMI classification were assessed according to age and sex. Medical expenses comprised those for medication and combined outpatient department (OPD) and hospitalization services. Means and 95% confidence intervals were analyzed using a two-part model. Results: Average annual medical expenses increased in higher BMI quintile groups (P for trend <0.001). Average annual medical expenses per person increased significantly as BMI increased in women but not in men. Average annual medical expenses were highest in the highest quintile of BMI among women and in all age groups.While BMI showed a U-shape association with medical expenses for OPD and hospitalization in young individuals, medical expenses for medication in all age groups and those for OPD and hospitalization in middle-aged individuals increased sharply in the highest BMI quintile. Conclusion All types of average annual medical expenses increased in higher BMI groups in Korean adults, particularly in women. Individuals with the highest BMI quintile incurred the greatest medical expenses among women and across all age groups. Strategies for preventing and managing obesity are warranted to reduce the burden of obesity-related medical expenses.